Provider Demographics
NPI:1104834001
Name:HABER, STEVEN M
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:HABER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 ANDERSON AVE
Mailing Address - Street 2:OFFICE C
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-1734
Mailing Address - Country:US
Mailing Address - Phone:201-224-0094
Mailing Address - Fax:201-224-0095
Practice Address - Street 1:1319 ANDERSON AVE
Practice Address - Street 2:OFFICE C
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-1734
Practice Address - Country:US
Practice Address - Phone:201-224-0094
Practice Address - Fax:201-224-0095
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11831122300000X
NY0311221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HA110880Medicare UPIN
NJHA110880Medicare ID - Type Unspecified